De Medicina |
Translator: Walter George Spencer
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| 45 |
EVOCARE uero materiam multa admodum possunt , sed ea cum ex peregrinis medicamentis maxime constent , aliisque magis , quam quibus ratione uictus succurritur , opitulentur , in praesentia differam : ponam uero ea , quae prompta et is morbis , de quibus protinus dicturus sum , apta corpus erodunt , et sic eo quod mali est extrahunt . Habent autem hanc facultatem semen erucae , nasturcii , radiculae , praecipue tamen omnium sinapi . Salis quoque et fici eadem uis est . Leniter uero simul et REPRIMVNT et molliunt lana sucida quo cum aceto uel uino oleum adiectum est , contritae palmulae , furfures in salsa aqua uel aceto decoctae . At simul et reprimunt et refrigerant herba muralis ( ΠΑΡΘΕΝΙΟΝ uel ΠΕΡΔΕΙΚΙΟΝ appellant ) , serpullum , puleium , ocimum , herba sanguinalis , quam Graeci ΠΟΛΥΓΟΝΟΝ uocant , portulaca , papaueris folium , capriolique uitium , coriandrum , folia hyoscyamu , muscus , siser , apium , solanum ( quam strychnon Graeci uocant ) , brassicae folia , intubus , plantago , feniculi semen ; contrita pira uel mala , praecipueque Cotonea , lenticula ; aqua frigida , maximeque pluuialis , uinum , acetum , et horum aliquo madens uel panis uel farina uel spongia uel cinis uel lana sucida uel etiam linteolum ; creta Cimolia , gypsum ; melinum , murteum , rosa , acerbum oleum ; uerbenarum contusa cum teneris colibus folia ; cuius generis sunt olea , cupressus , myrtus , lentiscus , tamarix , ligustrum , rosa , rubus , laurus , hedera , Punicum malum . Sine frigore autem reprimunt cocta mala Cotonea , malicorium , aqua calda , in qua uerbenae coctae sunt , quas supra posui , puluis uel ex faece uini uel ex murti foliis , amarae nuces . CALFACIT uero ex qualibet farina cataplasma siue ex tritici siue farris siue hordei siue erui siue lolii siue milii uel panicii uel lenticulae uel fabae uel lupini uel lini uel feni Graeci , ubi ea defer uuit calidaque inposita est . Valentior tamen ad id omnis farina est ex mulso quam ex aqua cocta . Praeterea cyprinum , irinum , medulla , adeps ex fele , oleum , magisque si uetus est , iunctaque oleo sal , nitrum , git , piper , quinquefolium . Fereque quae uehementer reprimunt et refrigerant , durant : quae calfaciunt , digerunt et emolliunt , praecipueque ad emolliendum potest cataplasma ex lini uel feni Graeci semine . His autem omnibus , et simplicibus et permixtis , uarie medici utuntur , ut magis quid quisque persuaserit sibi appareat , quam quid euidenter compererit .
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33 For drawing out the material of the disease certainly many things can be used, but as they are mostly composed of foreign medicaments and are more useful in other affections than in those relieved by the dietetic regimen, I will defer their consideration for the present (V. Proem., 1, 2): but I will mention here those which are at hand, and are suitable to the diseases of which I am about to speak (III, IV), since they blister the body and thus extract from it the material of disease. Now those which have this faculty are the seeds of rocket, cress, radish, and most of all mustard. The same faculty exists in salt and figs. Those which gently both repress and mollify at the same time are greasy wool to which has been added oil with vinegar or wine, crushed dates, bran boiled in salt water or vinegar. But those which simultaneously repress and cool are pellitory, which the Greeks call parthenion or perdeikion, thyme, pennyroyal, basil, the blood-herb which the Greeks call polygonon, purslane, poppy-leaf, vine-tendril, coriander, hyocyamus-leaves, moss, skirret, parsley, solanum, which the Greeks call strychnos, cabbage-leaves, endive, plantain, fennel-seed; crushed pears and apples and especially quinces, lentils; cold water, especially rain water, wine and vinegar, and everything soaked in these, whether bread or meal or sponge or ashes, or greasy wool or even lint; Cimolian chalk, gypsum; oil perfumed with quince, myrtle, rose; unripe olive oil; vervains, the leaves crushed along with their young twigs, of which sort are the olive, cypress, myrtle, mastic, tamarisk, privet, rose, bramble, laurel, ivy, and pomegranate. Those which repress without cooling are cooked quinces, pomegranate rind, hot water in which the vervains enumerated above have been boiled, powdered wine lees or myrtle leaves, bitter almonds. But those which are heating are poultices made of meal, whether of wheat or spelt or barley or bitter vetches or darnel or millet or panic or lentil or bean or lupin or linseed or fenugreek, when one of these has been boiled and applied hot. All forms of meal poultices, however, are rendered more efficacious by cooking in mead instead of in water. Besides there are: cyprus or iris oil, marrow, cat's fat, olive oil, especially if it is old, and there has been added to the oil salt, soda, black cummin, pepper, cinquefoil. Generally those which are powerful to repress inflammation, and cool, harden the tissues; those which are heating, disperse inflammation and soften, and this last property belongs especially to plasters of linseed or fenugreek seeds. But as regards all these medicaments, whether used as simples or in mixtures, their uses by medical men vary, so that it is clear that each man follows his own ideas rather than what he has found to be true by actual fact. |
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Prouisis omnibus , quae pertinent ad uniuersa genera morborum , ad singulorum curationes ueniam . Hos autem in duas species Graeci diuiserunt , aliosque ex his acutos , alios longos esse dixerunt . Ide mque quoniam non semper eodem modo respondebant , eosdem alii inter acutos , alii inter longos rettulerunt ; ex quo plura eorum genera esse manifestum est . Quidam enim breues utique sunt , qui cito uel tollunt hominem , uel ipsi cito finiuntur ; quidam longi , sub quibus neque sanitas in propinquo neque exitium est ; tertiumque genus eorum est , qui modo acuti , modo longi sunt , idque non in febribus tantummodo , in quibus frequentissimum est , sed in aliis quoque fit . Atque etiam praeter hos quartum est , quod neque acutum dici potest , quia non peremit , neque utique longum , quia , si occurritur , facile sanatur . Ego cum de singulis dicam , cuius quisque generis sit indicabo . Diuidam autem omnes in eos , qui IN TOTIS CORPORIBVS consistere uidentur , et eos , qui oriuntur in partibus . Incipiam a prioribus , pauca de omnibus praefatus . In nullo quidem morbo minus fortuna sibi uindicare quam ars potest : ut pote qu om repugnante natura nihil medicina proficiat . Magis tamen ignoscendum medico est parum proficienti in acutis morbis quam in longis : hic enim breue spatium est , intra quod , si auxilium non profuit , aeger extinguitur : ibi et deliberationi et mutationi remediorum tempus patet , adeo ut raro , si inter initia medicus accessit , obsequens aeger sine illius uitio pereat . Longus tamen morbus cum penitus insedit , quod ad difficultatem pertinet , acuto par est . Et acutus quidem quo uetustior est , longus autem quo recentior , eo facilius curatur . Alterum illud ignorari non oportet , quod non omnibus aegris eadem auxilia conueniunt . Ex quo incidit , ut alia atque alia summi auctores quasi sola uindicarint , prout cuique cesserat . Oportet itaque , ubi aliquid non respondet , non tanti putare auctorem quanti aegrum , et experiri aliud atque aliud , sic tamen ut in acutis morbis cito mutetur quod nihil prodest in longis , quos tempus ut facit sic etiam soluit , non statim condemnetur , si quid non statim profuit , minus uero remoueatur , si quid paulum saltem iuuat , quia profectus tempore expletur .
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Book III 1 Having dealt with all that pertains to whole classes of diseases taken together, I come to the treatment of diseases one by one. Now the Greeks divided these into two species, terming some acute, others chronic. But because maladies did not always respond in the same way to treatment, some of the Greek writers have placed among the acute what others have placed among the chronic; from this it is clear that there are more than two classes. For some diseases are certainly of short duration, which carry off the patient quickly, or themselves come quickly to an end; some are chronic, in which neither recovery is near at hand nor death; and there is a third class, at one time acute, at another time chronic, and that occurs not only in fevers, where it is most frequent, but in other affections also. And besides the above there is a fourth class which cannot be said to be acute, because it is not fatal, nor really chronic, because if treated it is readily cured. When I come myself to speak of diseases singly, I will point out to which class each belongs. But I shall divide all diseases into those which appear to have their seat in the body as a whole, and into those which originate in particular parts. I shall begin with the former, after a few words of preface concerning all. Whatever the malady luck no less than the art can claim influence for itself; seeing that with nature in opposition the art of medicine avails nothing. There is, however, for a practitioner who is unsuccessful, more excuse in acute than in chronic diseases: for acute diseases are of short duration, within which the patient is snuffed out, if not benefited by the treatment: chronic diseases give time for deliberation, and for change of remedies, so that when the practitioner is in attendance from the commencement, it is seldom that a docile patient should perish unless by the practitioner's default. A chronic disease, nevertheless, when it has become deep-seated, is no less difficult to deal with than an acute one. And indeed the older an acute malady, the more recent a chronic one, the more easily it is treated. There is another point which should be borne in mind, that the same remedies do not suit all patients. Hence it is that the highest authorities proclaim as if they were the only remedies, now some, now others, each in accordance with what he has found successful. It is well, then, when any one remedy fails, to look not so much to the authority as to the patient, and to make trial, now of one, now of another remedy, taking care, however, that in acute diseases what is doing no good is changed quickly; in chronic diseases which it takes time to produce as well as to remove, if a remedy does not succeed at once, it should not be condemned at once, much less should it be discontinued if it is beneficial, though only to a small extent, because the progress is completed by time. |
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Protinus autem inter initia scire facile est , quis acutus morbus quis longus sit , non in is solis , in quibus semper ita se habet , sed in is quoque , in quibus uariat . Nam ubi sine intermissionibus accessiones et dolores graues urgent , acutus est morbus : ubi lenti dolores lentaeue febres sunt et spatia inter accessiones porrigunt , acceduntque ea signa , quae priore uolumine exposita sunt , longum hunc futurum esse manifestum est . Videndum etiam est , morbus an increscat , an consistat , an minuatur , quia quaedam remedia increscentibus morbis , plura inclinatis conueniunt ; eaque , quae decrescentibus apta sunt , ubi acutus increscens urget , in remissionibus potius experienda sunt . Increscit autem morbus , dum grauiores dolores accessionesque ueniunt , eaeque et ante , quam proximae , reuertuntur et postea desinunt . Atque in longis quoque morbis etiam tales notas non habentibus scire licet increscere , si somnus incertus est , si deterior concoctio , si foediores deiectiones , si tardior sensus , si pigrior mens , si percurrit corpus frigus aut calor , si id magis pallet . Ea uero , quae contraria his sunt , decedentis eius notae sunt . * * Praeter haec in acutis morbis serius aeger alendus est , nec nisi iam is inclinatis , ut primo dempta materia impetum frangat , in longis maturius , ut sustinere spatium adfecturi mali possit . Ac si quando is non in toto corpore sed in parte est , magis tamen ad rem pertinet uim totius corporis moliri quam proprie partis aegrae sanitatem . Multum etiam interest , ab initio quis recte curatus sit an perperam , quia curatio minus is prodest , in quibus adsidue frustra fuit . Si qui temere habitus adhuc integris uiribus uiuit , admota curatione momento restituitur . Sed cum ab is coeperim , quae notas quasdam futurae aduersae ualetudinis exhibent , curationum quoque principium ab animaduersione eiusdem temporis faciam . Igitur si quid ex is , quae proposita sunt , incidit , omnium optima sunt quies et abstinentia : si quid bibendum est , aqua , idque interdum uno die fieri satis est , interdum , si terrentia manent , biduo ; proximeque abstinentiam sumendus est cibus exiguus , bibenda aqua , postero die etiam vinum , deinde inuicem alternis diebus modo aqua modo uinum , donec omnis metus finiatur . Per haec enim saepe instans grauis morbus discutitur . Plurimique falluntur , dum se primo die protinus sublaturos languorem aut exercitatione aut balneo aut coacta deiectione aut uomitu aut sudationibus aut uino sperant ; non quo non interdum incidat aut non dec eper it sed quo saepius fallat , solaque abstinentia sine ullo periculo medeatur : cum praesertim etiam pro modo terroris moderari liceat , et , si leuiora indicia fuerunt , satis sit a uino tantum abstinere , quod subtractum plus , quam si cibo quid dematur , adiuuat ; si paulo grauiora , facile sit non aquam tantum bibere sed etiam cibo carnem subtrahere , interdum panis quoque minus quam pro consuetudine adsumere , umidoque cibo esse contentos et holere potissimum , satisque sit tum ex toto a cibo , a uino , ab omni motu corporis abstinere , cum uehementes notae terruerunt . Neque dubium est , quin uix quisquam , qui non dissimulauit sed per haec mature morbo occurrit , aegrotet .
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2 Now at their commencements, it is easy to recognize at once what is an acute disease, and what a chronic one, not only as regards those which take a uniform course, but also when the course is variable. For when severe paroxysms and pains are causing distress without intermission, the disease is acute: it becomes evident that the future course will be prolonged when there are but slight pains and fever, and when there are long intervals between the paroxysms, and there are in addition the signs which have been described in the preceding book. It is also to be noted whether the disease is increasing, or stationary, or lessening, because some remedies are suitable for increasing, more for declining maladies; and when an acute fever is increasing in urgency, remedies which are suitable in decreasing affections are to be tried rather during the remissions. A disease is increasing in urgency when pains and paroxysms occur with more severity, and when they both recur at shorter intervals, and desist later than before. And, in chronic diseases too, even if they do not present such characteristic signs, it may be recognized that the affection is increasing: if sleep is irregular; if digestion deteriorates; if the stools become more foul; the sense duller; the mind more sluggish; if a feeling of cold, or of heat, runs through the body, if the body becomes more pale. But opposite signs mark a decline in the disease. . . . In acute diseases, moreover, the patient is to be given food after more delay, and not until the paroxysm is already declining so that its force may be broken primarily by the withholding of nutriment; in chronic diseases, earlier, so that it may support the patient for the duration of his coming illness. But if sometimes, not the whole body, but a part only, is affected, still the support of the strength of the whole body rather than the curing by itself of the part diseased is of more importance. It makes a great difference also whether from the commencement the patient has been treated correctly or incorrectly, because treatment has less advantage in those cases in which a course has been persisted in without effort. If a patient lives through indiscreet treatment with his strength unimpaired, an appropriate treatment may restore him forthwith. But as I commenced (II.2) with those symptoms which show some signs of impending illness, I shall make a beginning as to treatment by noticing the same period. If, therefore, any of the signs then referred to occur, the best treatment is rest and abstinence; if anything at all is to be drunk, let it be water, and it is sufficient for this to be continued sometimes for one day, sometimes, when alarming signs persist, for two days; on the day following the fast, food should be taken sparingly, and water drunk; the next day even wine, and then in turn, on alternate days, water and wine, until all anxiety is at an end. For often in this way a severe disease is dispersed while it is impending. And many deceive themselves with the hope of getting rid of the languor straightaway on the first day, either by exercise, or by a bath, or by a purge, or by an emetic, or by sweating, or by drinking wine: not but that such a procedure may succeed or not disappoint, but more often it fails, and abstinence by itself is a remedy without any risk; especially since it also admits of being modified in accordance with the degree of apprehension, and if the indications are of the slighter kind, it is enough to abstain from wine alone, its withdrawal being more advantageous than if something were subtracted from the food; if they are of somewhat greater severity, it is easy to limit the drink to water, and at the same time to withdraw meat from the diet, sometimes also to use less bread than usual, and to be content with moist food, especially pot-herbs; and it is sufficient to abstain entirely from food and wine, and from all bodily movement, only when serious symptoms have given rise to alarm. Nor is there a doubt that scarcely anyone falls ill who has hidden nothing but has countered disease in good time by these measures. |
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Atque haec quidem sanis facienda sunt tantum cum causa metuentibus . Sequitur uero CVRATIO FEBRIVM quod et in toto corpore et uulgare maxime morbi genus est . Ex his una cotidiana , altera tertiana , altera quartana est . Interdum etiam longiore circuitu quaedam redeunt , sed id raro fit . In prioribus et morbi * sunt et medicina . Et quartanae quidem simpliciores sunt . Incipiunt fere ab horrore , deinde calor erumpit , finitaque febre biduum integrum est : ita quarto die reuertitur . Tertianarum uero duo genera sunt . Alterum eodem modo , quo quartana , et incipiens et desinens , illo tantum interposito discrimine , quod unum diem praestat integrum , tertio redit . Alterum longe perniciosius , quod tertio quidem die reuertitur , ex quadraginta autem et octo horis fere triginta et sex per accessionem occupat ( interdum etiam uel minus uel plus ) , neque ex toto in remissione desistit , sed tantum leuius est . Id genus plerique medici ΗΜΙΤΡΙΤΑΙΟΝ appellant . Cottidianae uero uariae sunt et multiplices . Aliae enim protinus a calore incipiunt , aliae a frigore , aliae ab horrore . Frigus uoco , ubi extremae partes membrorum inalgescunt , horrorem , ubi corpus totum intremit . Rursus aliae sic desinunt , ut ex toto sequatur integritas ; aliae sic , ut aliquantum quidem minuatur ex febre , nihilo minus tamen quaedam reliquiae remaneant , donec altera accessio accedat ; ac saepe aliae * * uix quicquam aut nihil remittant sed continuent . Deinde aliae feruorem ingentem habent , aliae tolerabilem : aliae cotidie pares sunt , aliae inpares , atque inuicem altero die lenior , altero uehementior * : aliae tempore eodem postridie reuertuntur , aliae uel serius uel celerius : aliae diem noctemque accessione et decessione implent , aliae minus , aliae plus : aliae cum decedunt , sudorem mouent , aliae non mouent ; atque alias per sudorem ad integritatem uenitur , alias tantum corpus inbecillius redditur . At accessiones etiam modo singulae singulis diebus fiunt , modo binae pluresue concurrunt . Ex quo saepe euenit , ut cotidie plures accessiones remissionesque sint , sic tamen , ut unaquaeque alicui priori respondeat . Interdum uero accessiones quoque confunduntur , sic ut notari neque tempora earum neque spatia possint . Neque uerum est , quod dicitur a quibusdam , nullam febrem inordinatam esse , nisi aut ex uomica aut ex inflammatione aut ex ulcere : facilior enim semper curatio foret , si hoc uerum esset : sed quod euidentes causae faciunt , facere etiam abditae possunt . Neque de re sed de uerbo controuersiam mouent , qui , cum aliter aliterque in eodem morbo febres accedunt , non easdem inordinate redire , sed alias aliasque subinde oriri dicunt ; quod tamen ad curandi rationem nihil pertineret , etiamsi uere diceretur . Tempora quoque remissionum modo liberalia , modo uix ulla sunt .
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3 These then are the things to be done by those, who, being in health, have cause merely to be apprehensive. Now there follows the treatment of fevers, a class of disease which both affects the body as a whole, and is exceedingly common. Of fevers, one is quotidian, another tertian, a third quartan. At times certain fevers recur in even longer cycles, but that is seldom. In the former varieties both the diseases and their medicines are of various kinds. Now quartan fevers have the simpler characteristics. Nearly always they begin with shivering, then heat breaks out, and the fever having ended, there are two days free; this on the fourth day it recurs. But of tertian fevers there are two classes. The one, beginning and desisting in the same way as a quartan, has merely this distinction, that it affords one day free, and recurs on the third day. The other is far more pernicious; and it does indeed recur on the third day, yet out of forty-eight hours, about thirty-six, sometimes less, sometimes more, are in fact occupied by the paroxysm, nor does the fever entirely cease in the remission, but it only becomes less violent. This class most practitioners term hemitritaion. Quotidian fevers, however, vary and have many forms. For some begin straightaway with a feeling of heat, others of chill, others with shivering. I call it a chill when the extremities become cold, shivering when the whole body shakes. Again, some desist so that complete freedom follows, others so that there is some diminution of the fever, yet none the less some remnants persist until the onset of the next paroxysm; and others often run together so that there is little or no remission, but the attacks are continuous. Again, some have a vehement hot stage, others a bearable one; some are every day equal, others unequal, and the paroxysm in turn slighter one day, more severe another: some recur at the same time the day following, some either earlier or later; some take up a day and a night with the paroxysm and the remission, some less, others more; some set up sweating as they remit, others do not; and in some, freedom is arrived at through sweating, in others the body is only made the weaker. But the paroxysms also occur sometimes once on any one day, sometimes twice or more often. Hence it often comes about that daily there are several paroxysms and remissions, yet so that each corresponds to one which has preceded it. But at times the paroxysms also become so confused together, that neither their durations nor intermissions can be observed. It is not true, as some say, that no fever is irregular unless as the outcome either of an abscess or of inflammation or of ulceration; for if this were true, the treatment always would be the easier, but what evident causes bring about, hidden ones can bring about also. And men are not arguing about facts but about words if, when during the same illness fevers come on in different ways, they say that these are not irregular returns of the same fever, but other different ones arising in succession; even though it were true, it would have nothing to do with the mode of treatment. The duration of remissions also is at times considerable, at other times scarcely of any length. |